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UnitedHealth Group Telephonic Care Navigator - Work From Home in New York, New York

If you are located within EST, you will have the flexibility to telecommute* (work from home) as you take on some tough challenges.

Energize your career with one of Healthcare’s fastest growing companies.

You dream of a great career with a great company – where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it’s a dream that definitely can come true. Already one of the world’s leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up.

This opportunity is with one of our most exciting business areas: Optum – a growing part of our family of companies that make UnitedHealth Group a Fortune 10 leader.

Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.

Our Telephonic Care Navigator have a serious responsibility to make every contact informative, productive, positive, and memorable for what it says about how much we care.

Part of the challenge here is dealing positively with members and providers in sometimes challenging circumstances. As a subject matter expert, you'll also be the “go-to” resource for information. The flexibility to work evening hours will also be required

This position is full - time (40 hours / week) Monday - Friday. Employees are required to have flexibility to work any of our 8 hour shift schedules during our normal business hours of 9:00 AM - 5:30 PM EST. It may be necessary, given the business need, to work occasional overtime. This is a telecommute / work at home role. If there are any system or performance issues, telecommute can be revoked for several reasons.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Primary Responsibilities:

  • Completes telephonic outreach to DSNP members utilizing auto dialer and manual dialing

  • Educates member on gaps in care and assists with scheduling provider appointments

  • Assists members with social determinants of health and links to community resources

  • Ensures member has access to PCP

  • Identifies gaps in care and assists in closure of gaps

  • Outreaches members on caseload consistent with program guidelines

  • Consistently meets metrics, both quality & performance

  • Provides excellent customer service to both members and providers

  • Constantly maintains schedule adherence and good attendance

  • Maintains confidential health information according to state and federal regulations including HIPAA

  • Act as a Subject Matter Expert for other team members

  • Manage the intake of members or the admission/discharge information post notification

  • Work with hospitals, clinics, facilities and the clinical team to manage requests for services

  • Manage the referral process, processing incoming and outgoing referrals and prior authorizations, including intake, notification and census roles

  • Resolve inquiries from members and/or providers

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

  • High School Diploma / GED (or higher)

  • 1+ years of call center and / OR telephonic customer service experience

  • 1+ years of professional experience in an office setting using the telephone and computer as the primary instruments to perform the job duties

  • 1+ years of Healthcare / Insurance experience and / OR Social Work / Community Outreach / Advocacy Experience

  • 1+ years of experience in analyzing and solving customer problems

  • Experience using Microsoft Word (edit, create, and save documents), Microsoft Excel (sorting and filtering data in spreadsheets), and Microsoft Outlook (emails, folders, attachments, and calendars)

  • Ability to work any 8-hour shift between the hours of 9:00 AM - 5:30 PM EST from Monday - Friday

  • Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance.

Preferred Qualifications:

  • Bachelor’s Degree (or higher) in Social Work, Public Health, OR related field

  • Bilingual Fluency in English and Spanish OR other language

  • Previous experience as a telecommuter

  • Medicaid and / OR Medicare experience

  • Experience working with medical terminology

Telecommuting Requirements:

  • Reside within EST

  • Required to have a dedicated work area established that is separated from other living areas and provides information privacy

  • Ability to keep all company sensitive documents secure (if applicable)

  • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

Soft Skills:

  • Must be able and comfortable with maintaining metrics and goals within the department

  • Must be comfortable working on the phone and multiple systems on the computer simultaneously while assisting members

  • Must be comfortable making outreach to members without prior engagement

  • Excellent Organizational Skills

  • Telephone etiquette

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Military & Veterans find your next mission: We know your background and experience is different and we like that. UnitedHealth Group values the skills, experience and dedication that serving in the military demands. In fact, many of the values defined in the service mirror what the UnitedHealth Group culture holds true: Integrity, Compassion, Relationships, Innovation and Performance. Whether you are looking to transition from active duty to a civilian career, or are an experienced veteran or spouse, we want to help guide your career journey. Learn more at https://uhg.hr/transitioning-military

Learn how Teresa, a Senior Quality Analyst, works with military veterans and ensures they receive the best benefits and experience possible. https://uhg.hr/vet

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health - related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work. SM

Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $17.12 to $30.34. The salary range for Connecticut / Nevada residents is $18.80 to $33.41. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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